Medical Billing AR Specialist – Appeals & Out-of-Network Expert
Are you a seasoned Medical Billing AR Specialist with deep expertise in appeals, denial management, and out-of-network claims? We want to hear from you. We are actively seeking a highly experienced, results-driven AR professional to join our fully remote team. This is not an entry-level role — we are looking for someone who has been in the trenches, knows the system, and has the track record to prove it. WHAT YOU'LL DO
- Manage and aggressively work AR across multiple specialties
- Lead appeals and denial management for complex and highdollar claims
- Handle outofnetwork billing, including underpaid claim disputes
- Work directly with payers using tools such as Data iSight, Zelis, and Patient Advocacy platforms
- Apply knowledge of the Independent Dispute Resolution (IDR) process and No Surprises Act (NSA) where applicable
- Identify trends in denials and implement strategies to reduce AR and increase collections
- Collaborate with clinical and administrative teams to ensure clean claim submission and followup
SPECIALTIES WE SERVE
- Surgical Spine
- Orthopedics
- Pain Management
- Ambulatory Surgery Centers (ASC)
- Laboratory
- Vascular Surgery
- Podiatry
- Plastic Surgery
- Neurosurgery
- Chiropractic
- Acupuncture
- Physical Therapy
REQUIREMENTS
- Minimum 5 years of medical billing AR experience in the specialties listed above
- Proven, measurable track record of reducing AR days and increasing revenue recovery
- Strong background in appeals, denial management, and outofnetwork claim resolution
- Experience with underpaid claim disputes and payer negotiation
- Familiarity with Data iSight and Zelis Patient Advocacy — required
- Knowledge of IDR/NSA processes — strongly preferred
- eClinicalWorks (eCW) and/or Modernizing Medicine (ModMed) experience — a plus
- Excellent written communication skills for appeal letter writing
- Selfmotivated, detailoriented, and able to work independently in a remote environment
GROWTH & ADVANCEMENT We don't just hire great people — we invest in them. High performers will have the opportunity to grow into senior, lead, and management roles as the company expands. If you are looking for a place to build a long-term career, not just fill a position, this is the right opportunity for you. COMPENSATION & BENEFITS
- Salary: $65,000 $70,000, based on experience
- Medical Insurance
- Dental Insurance
- 401(k) Plan
- 100% Remote Position
- Clear path for career advancement
If you are ready to bring your expertise to a team that values results and rewards performance, apply today. To apply, please submit your resume along with a brief summary of your AR reduction accomplishments and appeals experience. About Adelfi Medical Billing Solutions At Adelfi Medical Billing Solutions, we provide exceptional medical billing and revenue cycle management services to healthcare providers of all specialties. Our team of experienced professionals has the knowledge and expertise necessary to navigate the complexities of the healthcare billing industry, and we are committed to delivering accurate and timely payment for the services our clients provide. We believe in taking a proactive approach to medical billing, leveraging advanced technology and tools to optimize billing processes, reduce errors and denials. and identify opportunities for cost savings. At Adelfi Medical Billing Solutions, we understand that medical billing is not just about processing claims and collecting payments; it's about providing a high level of service that supports the goals and objectives of our clients. Apply tot his job Apply To this Job